Ebeling P, Stenman U H, Seppälä M, Koivisto V A
Second Department of Medicine, Helsinki University Hospital, Finland.
J Endocrinol. 1995 Jul;146(1):63-9. doi: 10.1677/joe.0.1460063.
The acute effects of hyperinsulinemia on androgen homeostasis and a possible association of androgens to insulin sensitivity, serum lipids and lipoproteins and to lipid oxidation were examined in 19 healthy males (27 +/- 1 yrs, body mass index 24 +/- 1 kg/m2). In each subject, a 240 min euglycemic hyperinsulinemic clamp was performed and glucose and lipid oxidation were determined by indirect calorimetry. During hyperinsulinemia serum sex hormone-binding globulin (SHBG) concentration decreased by 5% (P < 0.01), insulin-like growth factor binding protein (IGFBP-1) by 88% (P < 0.001) and dehydroepiandrosterone sulphate (DHEAS) by 12% (P < 0.001), with no change in total or free testosterone concentrations. In the basal state, IGFBP-1 and C-peptide were inversely related (r = -0.54, P < 0.05). Fasting concentrations of serum free testosterone (r = 0.59, P < 0.01) and DHEAS (r = 0.47, P < 0.05) correlated positively with serum free fatty acid (FFA) concentrations during hyperinsulinemia, but not with fasting FFA level. Lipid oxidation rate in the basal state correlated positively to the decline in SHBG (r = 0.61, P < 0.01) and DHEAS concentrations (r = 0.62, P < 0.01) during hyperinsulinemia. While the fasting serum high density lipoprotein cholesterol level correlated positively with the insulin-induced decline in DHEAS level (r = 0.58, P < 0.01), no associations were found between serum androgens and total cholesterol, low density lipoprotein cholesterol or triglyceride concentrations. Insulin sensitivity was not related to SHBG, IGFBP-1, DHEAS or testosterone concentrations.(ABSTRACT TRUNCATED AT 250 WORDS)
在19名健康男性(年龄27±1岁,体重指数24±1kg/m²)中,研究了高胰岛素血症对雄激素稳态的急性影响,以及雄激素与胰岛素敏感性、血清脂质和脂蛋白以及脂质氧化之间可能存在的关联。对每名受试者进行了240分钟的正常血糖高胰岛素钳夹试验,并通过间接量热法测定葡萄糖和脂质氧化。在高胰岛素血症期间,血清性激素结合球蛋白(SHBG)浓度降低了5%(P<0.01),胰岛素样生长因子结合蛋白(IGFBP-1)降低了88%(P<0.001),硫酸脱氢表雄酮(DHEAS)降低了12%(P<0.001),总睾酮或游离睾酮浓度无变化。在基础状态下,IGFBP-1与C肽呈负相关(r=-0.54,P<0.05)。空腹血清游离睾酮浓度(r=0.59,P<0.01)和DHEAS浓度(r=0.47,P<0.05)与高胰岛素血症期间的血清游离脂肪酸(FFA)浓度呈正相关,但与空腹FFA水平无关。基础状态下的脂质氧化率与高胰岛素血症期间SHBG的下降(r=0.61,P<0.01)和DHEAS浓度的下降(r=0.62,P<0.01)呈正相关。虽然空腹血清高密度脂蛋白胆固醇水平与胰岛素诱导的DHEAS水平下降呈正相关(r=0.58,P<0.01),但未发现血清雄激素与总胆固醇、低密度脂蛋白胆固醇或甘油三酯浓度之间存在关联。胰岛素敏感性与SHBG、IGFBP-1、DHEAS或睾酮浓度无关。(摘要截断于250字)